A large prospective cohort study analyzing data from 7499 participants in the China Health and Retirement Longitudinal Study found significant associations between changes in sarcopenia status and cardiovascular disease risk over a median follow-up of 9 years.
The study, published in BMC Medicine, demonstrated that compared to participants maintaining non-sarcopenic status, those who progressed from non-sarcopenia to possible sarcopenia or sarcopenia showed a 30% increased risk of new-onset cardiovascular disease (CVD).
Participants who recovered from sarcopenia to non-sarcopenia or possible sarcopenia demonstrated a 39% reduced risk of new-onset CVD compared to those with stable sarcopenia. Among those with baseline possible sarcopenia, recovery to non-sarcopenia was associated with a 33% lower risk compared to maintaining possible sarcopenia.
The baseline population included 4860 participants with non-sarcopenia, 1874 with possible sarcopenia, and 765 with sarcopenia, including 180 participants (2.4%) with severe sarcopenia. The study population was 50.8% female with a mean age of 58.5 years.
Detailed analysis of progression patterns revealed distinct clinical characteristics among groups. The non-sarcopenia group showed a mean BMI of 23.71 ± 3.72 kg/m², mean DBP of 75.93 ± 11.66 mmHg, and median CRP of 0.99 (0.53-2.00) mg/L. In contrast, the sarcopenia group demonstrated a lower mean BMI of 19.12 ± 1.84 kg/m², mean DBP of 72.51 ± 12.45 mmHg, and median CRP of 0.98 (0.53-2.36) mg/L.
The researchers employed the 2019 Asian Working Group for Sarcopenia algorithm, using specific cut-off values for diagnosis. Low grip strength was defined as <28 kg for men and <18 kg for women. ASM/Ht² cut-off values for men progressed from <7.01 kg/m² in 2011 to <7.07 kg/m² in 2015, while women's values increased from <5.31 kg/m² to <5.39 kg/m² over the same period.
Among participants without sarcopenia at baseline, 80.9% maintained stable status, while 14.6% progressed to possible sarcopenia and 4.6% to sarcopenia. Of those with possible sarcopenia at baseline, 57.7% recovered to non-sarcopenia, 38.5% remained stable, and 3.9% progressed to sarcopenia. Among participants with baseline sarcopenia, 39.1% recovered to non-sarcopenia, 9.8% improved to possible sarcopenia, and 51.0% remained stable.
The study documented a varying prevalence of comorbidities across groups. Diabetes mellitus was present in 11.52% of non-sarcopenic participants, 13.88% of those with possible sarcopenia, and 8.37% of sarcopenic individuals. Hypertension showed higher prevalence, affecting 33.99% of non-sarcopenic, 45.52% of possibly sarcopenic, and 41.18% of sarcopenic participants.
Subgroup analyses identified stronger associations in specific populations. Women progressing from non-sarcopenia to possible sarcopenia or sarcopenia showed a 45% increased risk of new-onset CVD. Participants aged 65 years and older who experienced progression demonstrated a 54% increased risk.
The study methodology included Cox proportional hazards models adjusted for multiple factors including demographic, lifestyle, and clinical parameters. CVD events were identified through self-reported physician diagnoses of heart disease or stroke, with 1,345 participants developing CVD during follow-up.
The findings remained consistent through multiple sensitivity analyses, including reassessment of sarcopenia status at a third survey point and additional adjustments for medication use. Study limitations included reliance on self-reported CVD diagnoses and inability to explore associations with specific types of heart disease due to data constraints.
The authors declared no competing interests.
